The nurse is caring for an infant who has been diagnosed with short bowel syndrome (SBS). The parent asks how the disease will affect the child. Select the nurse's best response.

Correct Answer: D

Rationale: The correct answer is option D: "The prognosis and course of the disease have changed because hyperalimentation (parenteral nutrition) is available." This response is the best choice because it provides the parent with updated information about the management of short bowel syndrome (SBS). Hyperalimentation, or parenteral nutrition, plays a crucial role in providing essential nutrients to individuals with SBS who are unable to absorb nutrients through the digestive tract. This intervention has significantly improved the outcomes and quality of life for patients with SBS, making it a more optimistic outlook for the child. Option A is incorrect because it only focuses on the aspect of constipation, which is not the primary concern in SBS. Option B is incorrect as it simplifies the impact of SBS on nutrient absorption without providing a comprehensive explanation. Option C is incorrect and lacks sensitivity and hope, which are essential when communicating with parents about their child's health condition. In an educational context, it is important for nurses to stay updated on the latest advancements in the management of pediatric gastrointestinal conditions like SBS. Providing accurate and current information to parents helps them understand the disease better and feel more confident in the care their child receives. This empowers parents to actively participate in their child's treatment and decision-making process, leading to better outcomes and improved family-centered care.

Correct Answer: D

Rationale: The correct response, D, instructs the mother to take the child to the emergency room immediately because the symptoms described (vomiting, bloody diarrhea, mucus) are indicative of intussusception, a serious condition where one part of the intestine slides into another part, causing a blockage. This is a medical emergency requiring prompt intervention to prevent complications like bowel perforation. Option A is incorrect because it lacks urgency in addressing the potentially life-threatening situation. Option B is also incorrect as waiting for another episode of vomiting before seeking medical attention can delay necessary treatment. Option C is incorrect as it assumes the symptoms are due to a formula allergy without considering the severity of the presentation. In an educational context, it's crucial for nurses to recognize red flag symptoms in pediatric patients that warrant immediate medical attention. Understanding the urgency of certain symptoms like bloody diarrhea in infants can help prevent delays in diagnosis and treatment of serious conditions like intussusception, ultimately improving patient outcomes.

Correct Answer: C

Rationale: The correct response is option C: "Your baby will likely swallow the formula regardless of the temperature because swallowing is a reflex in infants younger than 6 weeks." This response is the best choice because it accurately reflects the physiological reality of newborns. Swallowing is indeed a reflex in infants, especially in the early weeks of life, and they do not have the voluntary ability to spit out fluids based on their temperature preferences. Option A is incorrect because stating that babies tend to reject hot fluids but not cold fluids is not accurate. Cold fluids can also be rejected by babies, and hot fluids can pose a risk of burns rather than just abdominal discomfort. Option B is also inaccurate as it suggests that babies reject cold fluids, which might lead to esophageal burns. This is an extreme scenario and not a common response seen in infants. Option D is incorrect because even though infants are not capable of intentionally spitting out fluids due to their reflexive swallowing pattern, it is not due to their age but rather their developmental stage. In an educational context, it is crucial for nurses to provide accurate and evidence-based information to parents to promote the health and well-being of their newborns. Understanding the physiological capabilities of newborns helps caregivers make informed decisions and provide appropriate care for their infants.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) 13-year-old who has just started her menses. During menstruation, females may experience increased fluid loss due to blood loss, which can put them at risk for dehydration. Providing extra fluids during this time can help maintain hydration levels. Option A) 7-day-old receiving phototherapy typically needs strict fluid management due to the risk of fluid overload, making extra fluids not recommended in this case. Option B) A 6-month-old with newly diagnosed pyloric stenosis may experience vomiting, leading to fluid loss; however, the priority in this situation is to address the underlying condition and ensure adequate intake rather than just increasing fluids. Option C) A 2-year-old with pneumonia may also be at risk for dehydration due to fever and increased respiratory rate, but the focus of care would be on treating the pneumonia and ensuring adequate hydration rather than just providing extra fluids. Educationally, it is essential for pediatric healthcare providers to understand the specific needs of children in different clinical situations to provide individualized care. Understanding the factors that can contribute to dehydration in children, such as increased fluid loss during menstruation in adolescents, is crucial for effective nursing interventions to prevent complications related to dehydration.

Correct Answer: B

Rationale: Necrotizing enterocolitis (NEC) is a serious condition in infants characterized by inflammation and tissue death in the intestines. Bloody diarrhea is a key manifestation of NEC due to the damage and necrosis occurring in the intestinal lining, leading to blood in the stool. This is a critical indicator that the infant may be developing NEC and requires immediate medical attention. Option A, absorption of bolus orogastric feedings at a faster rate, is not indicative of NEC. NEC typically presents with feeding intolerance, abdominal distension, and other systemic signs rather than an increase in absorption rate. Increased bowel sounds (Option C) can be a nonspecific finding and may occur in various gastrointestinal conditions. It is not specific to NEC and does not provide a definitive indication of NEC development. An infant appearing hungry right before a scheduled feeding (Option D) is also a nonspecific finding and does not directly correlate with NEC. Hunger cues are common in infants and do not necessarily suggest NEC. In an educational context, understanding the specific manifestations of NEC is crucial for pediatric nurses to promptly identify and intervene in cases of NEC. Early recognition and appropriate management are essential in improving outcomes for infants with NEC. Nurses must be vigilant in assessing for signs like bloody diarrhea to ensure timely intervention and prevent complications associated with NEC.